The Test

Mom was referred to a geriatric neuropsychiatric practice called "Generations" for Alzheimer's testing. On the days leading up to the test, she would ask me to remind her who the vice president of the United States is and did I think she would have to count backwards from 100 because she never could do that anyway. I said, "Mom, this isn't a test you study for."

The testing itself was impressive. Mom and I were interviewed together for 15 minutes by Dr. Bouregard and then I was excused and he continued with Mom for over an hour. On the drive home, Mom said, "It wasn't bad at all. He told me a story about a little girl who wouldn't eat her spaghetti and then asked me to tell him the story again a couple of times. He showed me pictures of animals, like lions and elephants and I had to tell him what they were. Can you imagine, Donna? But he said I did real good. I don't think I have Alzheimer's, do you?"

"Maybe not, Mom. We'll have to wait and see what they say."

At the follow-up visit, both Dr. Bouregard and Dr. Vadalia, the head of the practice, sat down with us in a small conference room to go over the test results. After explaining that the test is designed to identify whether people have normal aging memory loss or Alzheimer's, they said the words Mom didn't expect to hear: "You are in early stage Alzheimer's." As she sat beside me, I could sense her shutting down, growing very quiet and frightened at the news.

"Why doesn't God just take me right now?" she murmured to me. I put my arm around her. I knew how devastated she was. Dr. Vadalia asked her what she knew about Alzheimer's and Mom told him about people she had seen with it in the nursing home she worked in as a nurse's aide many years ago. How they didn't know anyone and couldn't feed themselves. She said she didn't want to be like that. Dr. Vadalia explained the stages of Alzheimer's and reassured her she was no where close to being like those people. He told us about the value of medications, socialization, and exercise that helped slow the progression of the symptoms. Mom grew very quiet.

Thoughts raced through my head about how to increase her socialization. Did I hear him say she needed socialization of a minimum of five hours a day, five days a week? Her long phone conversations with her sisters didn't count. She needed to talk to people face to face. No, television certainly didn't count either, in fact, she shouldn't watch much TV at all. They were optimistic that if we could do these three things--the medication Aricept, increased socialization, and get her out walking--then the symptoms, e.g., memory loss, could be controlled and manageable until she progressed through to second stage Alzheimer's. And the disease would progress; nothing will stop that. And there were other medications for the advancing stages.

We talked some on the drive home as I tried to help her understand what they had said. "I just hate the thought of going into a nursing home, Donna. I've worked in them. I know what they're like." It was clear her greatest fear was giving up her life in the apartment over our garage. "That decision is way in the future, Mom. We will do everything we can to keep you in your apartment as long as possible."